Why the health care infrastructure must be rebuilt

You’re nearly twice as likely to die from colon cancer living in a Latin American country than you are living in the United States.

Global health leaders are trying to fix this disparity. But unfortunately, they’ve misdiagnosed the problem.

Some countries and activist groups continue to blame the problem on intellectual property protections for pharmaceuticals. They argue that allowing companies to patent new drugs prevents patients in Latin America and other developing regions from accessing lifesaving medicines. They want to eliminate patents altogether, theoretically making it easier to create cheap generic drugs.

This strategy is certain to fail. Effective intellectual property protection and enforcement encourages medical research and development. Weakening patents would reduce, not expand, people’s access to cutting-edge cures. It’s time for countries to take a new, more practical approach to improving access to medicines.

They’ll have a chance in September at the United Nations in New York, where world leaders will meet to discuss non-communicable diseases like cancer. These leaders should focus on improving health care infrastructure in the developing world. Chronic diseases are on the rise in developing countries. And they’re ill-prepared for this scourge.

Consider colon cancer. Right now, the condition is much less prevalent in Latin America than in North America. In Latin America, there are 11 cases per 100,000 people. In North America, there are 30 cases per 100,000.

But that could soon change. Many countries are beginning to adopt more Americanized diets and lifestyles, which experts believe may increase one’s risk of developing colon cancer. Sales of processed foods in developing countries are growing almost 30 percent annually.

That will cause the global burden of colon cancer to nearly double by 2035. All told, non-communicable diseases will account for 70 percent of fatalities in developing countries by 2020.

Unfortunately, the developing world lacks the resources to treat these diseases. Honduras, for instance, has only 30 doctors per 100,000 people. The United States has more than six times that amount.

Latin America’s doctors are ill-prepared to handle an increase of chronic diseases. Already, more than 452 people per 100,000 develop a chronic disease in Latin America, compared to 78 for communicable diseases.

It costs more than $2 billion to bring a new medicine to market. Intellectual property protections such as patents help researchers earn back this investment and encourage them to take this risk again and again.

Without these protections, companies would scale back drug development. Eventually, that would lead to fewer lifesaving treatments. Patients around the world would suffer.

Anti-intellectual property actions wouldn’t even boost short-term access to medicines. Already, more than 90 percent of the medicines on the World Health Organization’s list of “essential medicines” are off-patent. Intellectual property simply isn’t a barrier to access for people in the developing world.

But anti-IP measures and poor IP-enforcement are barriers to care. And they abound in Latin America.

Many countries, for instance, struggle to grant patents in timely fashions, which delays patients’ access to these innovative drugs. In Argentina, for example, patent approvals take an average of six years. In Brazil, they can take more than 10.

Some Latin American countries also don’t respect patents. Brazil, for instance, abuses “compulsory licensing.” This policy allows for the production of a patented product without approval from the patent owner. It’s generally reserved for public health emergencies. Think Zika.

But Brazil grants compulsory licenses even when there isn’t a public health crisis. In 2007, for instance, the government allowed Brazilian companies to reproduce the U.S. anti-retroviral Efavirenz for 77,000 patients.

That prevented its U.S. creator, Merck, from recouping the massive research and development investments it made to create the life-extending drug. There’s no incentive or security for drug companies to innovate if countries can copy patented, costly drugs at the drop of a hat.

The developing world is on the brink of a chronic disease epidemic. At the upcoming U.N. meeting on non-communicable diseases, countries must combat it by improving health care infrastructure while also encouraging innovation.

• Andrew Spiegel, a lawyer, is co-founder and executive director of the Global Colon Cancer Association and a board member of the International Alliance of Patients’ Organizations.